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Re: Trim and sleep » Cece

Posted by fachad on June 13, 2002, at 12:34:11

In reply to Trim and sleep » fachad, posted by Cece on June 13, 2002, at 0:54:44

Cece,

Suggestions:

increase trimip dose
try doxepin
try ambien
try sleep restriction


Funny that you say you have "reverse SAD". I've always told my docs that I have that, and they smiled at me like, "sure, whatever". But I really do much worse in the summer.

Quality of sleep is a very slippery thing. People who take benzos will report that they believe that they had good sleep, but a polysomnigraph will say otherwise.

We tend to think of sleep like pain, where if you say, "I am in pain", your subjective experience of pain is truly the essence of pain. But in reality, sleep is a physical function that can be measured, and there is not always total correlation between subjective quality and objective quality of sleep.

One thing I discovered about why I seem to sleep better on benzos is the amnesia they cause. I dream a lot, I wake up, but I forget that I had dreamed and waked in the night.

If you have reduced your dose of benzo recently, that could cause rebound REM; if that is it, it will go away with some time.

As far as to what to do, ask your pdoc if you could take more trimip and see if that helps. Or you could try doxepin, which does suppress REM some which may be what you need.

Have you ever tried Ambien? It's very short acting, but it is quite powerful and does not disturb sleep like benzos.

Finally, I think the stuff about sleep hygiene is over hyped by benzo-phobic docs, but it is good to make sure you are not missing anything here.

And the most powerful thing to induce deep quality sleep is still sleep deprivation / sleep restriction. If you are not sleeping well in an 8 hour night, try a 7 hr. sleep period the next night, if poor sleep a 6 hr night etc. Get up earlier is far better than staying up later - it really does make a difference.

> Hi Fachad-
>
> I've posted earlier on this thread, but have some new developments/questions/feedback.
>
> I've been taking 25 mg Trim for over 6 mos. having switched from Nortiptyline- my pdoc thought that it would give me less morning grogginess and better sleep. And it did.
>
> But I've been weaning off benzos, and since my nighttime dose of xanax has gone from .75mg to .25mg I have been dreaming 'too much'. And I have not been falling asleep very fast, which is okay cuz I used to fall out like a log, and sleeping more restlessly which is not so okay. My body temp is fine and I don't wake up too early.
>
> I used to have a problem with spending too much time in REM sleep and not enough in the deeper restorative level. I would wake up feeling like I had been working all night. My various combo of meds seemed to take care of that. (I was diagnosed a few years ago with "Upper Airway Obstructive Disorder"- a step below sleep apnea, and set up with a CPAP machine- but eventually decided that it was a crock (a long story)).
>
> Anyway, I thought that you had said that Trim promotes deep level sleep- ? If that's so, am I just adjusting to less benzo? I really need that deep sleep.
>
> My pdoc has just encouraged me to take a small dose of zyprexa (1/4 to 1/2 of a 2.5mg tab) regularly as I am becoming destabilized by summer's approach (I have reverse SAD). I have taken it very occassional PRN at that dose and it definitely makes me saner, but I dread the weight gain. I took half a tab yesterday and slept better last night.
>
> So now I'm confused- again- and wondering what to do. Take the zyprexa and deal with the weight somehow? Take more Trim? Going back up on benzos is out- I need to clear my brain of their cobwebs, and you said earlier that benzos mess with "sleep architecture".
>
> You seem to be pretty knowledgeable; do you have any feedback to offer?
>
> Thanks, Cece


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